Audit 310584

Title: A.    Basis of Presentation Accounting Policies: B. Summary of Significant Accounting Policies The accompanying schedule of expenditures of federal awards includes the federal activity of the Hospital under programs of the federal government for the year ended September 30, 2023 and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: Not applicable to PRF program The accompanying schedule of expenditures of federal awards includes the federal awards activity of Marion County Hospital District #1 of Marion County, Kansas d/b/a St. Luke Hospital and Living Center (the Hospital) under programs of the federal government for the year ended September 30, 2023. The accompanying schedule presents total expenditures in accordance with Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Therefore, the amounts presented in this schedule may differ from the amounts presented in, or used in, the preparation of the basic financial statements.

Title: B. Summary of Significant Accounting Policies Accounting Policies: B. Summary of Significant Accounting Policies The accompanying schedule of expenditures of federal awards includes the federal activity of the Hospital under programs of the federal government for the year ended September 30, 2023 and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: Not applicable to PRF program The accompanying schedule of expenditures of federal awards includes the federal activity of the Hospital under programs of the federal government for the year ended September 30, 2023 and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance.

Title: C. Provider Relief Fund Reporting Accounting Policies: B. Summary of Significant Accounting Policies The accompanying schedule of expenditures of federal awards includes the federal activity of the Hospital under programs of the federal government for the year ended September 30, 2023 and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: Not applicable to PRF program The Hospital received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund and American Rescue Plan Rural Distribution (PRF) program (Federal Financial Assistance Listing #93.498). PRF amounts are to be reported based on the dates actually received. Period 1 reporting encompassed amounts received from April 10, 2020 through June 30, 2020 with a measurement date for use of funds through June 30, 2021. Period 2 reporting includes amounts received from July 1, 2020 through December 31, 2020 with a measurement date for use of funds through December 31, 2021. Period 3 reporting includes amounts received from January 1, 2021 through June 30, 2021 with a measurement date for use of funds through June 30, 2022. Period 4 reporting includes amounts received from July 1, 2021 to December 31, 2021 with a measurement date for use of funds through December 31, 2022. Period 5 reporting includes amounts received from January 1, 2022 to June 30, 2022 with a measurement date for use of funds through June 30, 2023. Accordingly, the amounts included on the accompanying schedule of expenditures of federal awards are for PRF subject to periods 4 and 5 reporting. The PRF expenditures are not recognized on the schedule until the expenditures are included in the reporting to HHS as required under the PRF program resulting in the Hospital’s recognition and reporting for financial statement purposes not matching with the PRF reporting timeline. A reconciliation of total expenditures of periods 4 and 5 PRF awards to amounts recognized in the Hospital’s financial statements is as follows:

Title: D. Indirect Cost Rate Accounting Policies: B. Summary of Significant Accounting Policies The accompanying schedule of expenditures of federal awards includes the federal activity of the Hospital under programs of the federal government for the year ended September 30, 2023 and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: Not applicable to PRF program The Hospital has not elected to use the 10% de minimus indirect cost rate as allowed under the Uniform Guidance.